Billing and Coding: MolDX: Short Tandem Repeat (STR) Markers and Chimerism (CPT® codes 81265-81268)
A54830
MolDX covers short tandem repeat (STR) chimerism testing (CPT 81265–81268) when performed for transplant recipient/donor testing and for monitoring engraftment or disease recurrence. CPT 81265 (recipient/donor testing) is reported as one unit and is ordinarily limited to once per lifetime (exceptions via appeal); CPT 81266 is covered for additional double-cord blood samples in bone marrow transplants, CPT 81267 is used post-transplant for engraftment/recurrence confirmation and pre/post comparisons, and CPT 81268 is used for buccal/germline recipient specimens post-transplant. Tests for twin zygosity are statutorily excluded and will be denied, and specific claim-combination rules and SV101-7 DEX Z-Code formatting requirements must be followed.
"Chimerism analysis to identify appropriate donors and to monitor engraftment success or disease recurrence for transplant patients is a covered Medicare service."